I see it every week: A person who is sad, having difficulty functioning or concentrating, crying frequently. Some have anxiety, other feel achy all over, still others sleep too much or too little. Most say that they feel utterly alone. This is depression.
Depression affects around 19 million Americans at any one time. And treatment does help reduce symptoms and in most cases cause remission of the disease.
How to determine if the sad feelings are true depression or just the blues is a real clinical call that can be determined by a trained medical professional.
Most people know that depression causes a person to feel sad, empty or hopeless most every day. He or she may be anxious or moody. People with depression tend to lose interest in doing things they used to enjoy and have difficulty making decisions.
Often a depressed person has an exaggerated sense of worthlessness or guilt. And most worrisome, a depressed person may wish themselves dead or make plans to harm themselves.
Depression can have physical symptoms too: Headaches, back pain, muscle and joint pains, diarrhea.
But what I often see is a person with a chronic illness, usually one that causes pain whose disease symptoms are MAGNIFIED by the depression. According to the American Pain Foundation, one-quarter to one-half of patients who complain of pain to their physicians are depressed.
With herpes, depression is often complicated by the unfortunate stigma that is attached to having the disease AND the stress that having an STD places on a person and their relationships. This is a tough situation where I must help the patient recognize that depression is worsening their illness, treat both problems and most importantly moderate their expectations.
The first thing I do is confront the problem and ask my patients to acknowledge their depression, the pain (physical and emotional), and whatever pyschosocial issues they are coping with regarding their diagnosis. I find that it is only through recognizing the interplay of the herpes diagnosis, the often disabling symptoms and the social issues they face that treatment can be s effective.
Once a person understands the chronicity and relapsing nature of herpes and has faced whatever social issues occur in people with herpes, the treatment of depression is similar to treat depression in other people.
Often, I use one of several antidepressants, choosing the antidepressant based on the effects I'm looking to get: treating anxiety, insomnia, avoiding impotence (a side effect of many antidepressants), cost and treating pain.
The fact that chronic pain and depression involve the same nerves and neurotransmitters means that antidepressants can be used to improve both chronic pain and depression.
In some patients, I also recommend therapy.
Exercise is the farthest thing from the mind of most people with depression. But regular physical activity CAN help depression (and decrease pain) - it's a natural antidepressant.
Depression CAN be overcome. The first step is to seek treatment.